Assess Your Cardiometabolic Risks With Adiposity Ratio Calculator
Your waist tells a story your weight can’t. The NowPatient Adiposity Ratio Service uses your Waist-to-Height Ratio (WHtR), the NICE-endorsed measure of central fat, to flag your real risk of Type 2 Diabetes, cardiovascular disease, and metabolic syndrome. Free, automatic, and always up to date, it alerts you when your risk changes and tracks your progress over time.
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Your Guide to Using the Adiposity Ratio App Feature
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SERVICE GUIDE
How Adiposity Ratio Works
What Is the Adiposity Ratio Service?
The Adiposity Ratio Service is a clinical risk assessment that calculates your Waist-to-Height Ratio (WHtR) to determine your level of central (visceral) adiposity. Central adiposity is a key indicator of cardiometabolic risk, including risk of Type 2 Diabetes, cardiovascular disease, and metabolic syndrome.
The WHtR has been endorsed by NICE (National Institute for Health and Care Excellence) as a simple and effective screening tool for identifying individuals at increased cardiometabolic risk. A boundary value of WHtR 0.5 as a risk assessment tool was first suggested in 1996 by Ashwell and Cole, and has since been validated across numerous global populations. The message ‘keep your waist circumference to less than half your height’ is now recommended by NICE (October 2022) as a simple and effective public health message.
A key advantage of WHtR is that the same threshold values apply across all adult ages, both sexes, and all ethnic groups — avoiding the need for age, sex, and ethnic-specific boundary values.
The Adiposity Ratio Service is classified as a Class I medical device under UK MDR 2002 regulations for its intended use. It is free for all registered NowPatient users.
How to Access Your Adiposity Ratio Score
Navigate to the ‘Personalised Insights’ section of your account homepage to find the Adiposity Ratio Service Card.
If you completed your Health Profile when you first created your NowPatient account, your Adiposity Ratio will be automatically calculated and displayed within the Service Card.
If the Health Profile was not completed, the card will appear locked. Select the ‘Unlock’ button and complete the series of questions. Once finished, you will be redirected to the account homepage where your score will be displayed on the Adiposity Ratio Service Card.
What Information Is Used to Calculate Your Score?
The Adiposity Ratio Service uses the following data from your Health Profile:
- Waist circumference (cm or inches)
- Height (cm, metres, or feet/inches)
How Is the Adiposity Ratio Calculated?
The Waist-to-Height Ratio is calculated using the following formula:
WHtR = Waist Circumference (cm) ÷ Height (cm)
Example: A patient with a waist circumference of 85 cm and height of 170 cm would have a WHtR of 0.50 (85 ÷ 170 = 0.50).
Why Does Waist Circumference Matter for Your Health?
Measuring your waist circumference is important because it tells you about your central adiposity — the amount of fat stored around your middle. This type of fat, known as visceral fat, is stored around your internal organs and is more harmful to your health than fat stored elsewhere on your body, such as on your hips or thighs.
Research shows that central adiposity is a stronger predictor of serious health conditions than overall body weight or BMI alone. People with excess fat around their waist are at significantly higher risk of:
- Type 2 diabetes
- Heart disease and stroke
- High blood pressure
- Abnormal cholesterol levels
- Metabolic syndrome
- Sleep apnoéa
The simple message from NICE is: “Keep your waist circumference to less than half your height.” By measuring your waist regularly, you can monitor whether your central fat levels are in a healthy range and take action if they are not.
Even if your overall weight or BMI appears normal, you may still have harmful levels of visceral fat. This is why waist measurement provides valuable information that weight alone cannot.
How Should I Measure My Waist Circumference?
According to WHO guidance, waist circumference should be measured:
- At the midpoint between the lower margin of the last palpable rib and the top of the iliac crest
- With you standing, arms relaxed at sides
- At the end of a normal expiration (breathing out)
- Using a non-elastic measuring tape held snugly without compressing the skin
NowPatient recommends measuring your waist at the same time of day each month — for example, first thing in the morning — for the most consistent results.
- At the midpoint between the lower margin of the last palpable rib and the top of the iliac crest
- With you standing, arms relaxed at sides
- At the end of a normal expiration (breathing out)
- Using a non-elastic measuring tape held snugly without compressing the skin
What Do the Adiposity Ratio Scores Mean?
The table below explains each risk category, what your WHtR score means, and the recommended actions.
| WHtR Value | Risk Category | What to Do |
| Below 0.4 | Underweight Risk | Your WHtR suggests you may have insufficient body fat. This could indicate being underweight. You should speak to your doctor to discuss whether further assessment is needed. |
| 0.4 to < 0.5 | Healthy Range | Your waist is less than half your height. You are classed as healthy with no increased health risk from central adiposity. You do not need to take any action, however, you can discuss this with your doctor at your next appointment. Continue to maintain healthy lifestyle habits. |
| 0.5 to < 0.6 | Increased Risk | Your waist is more than half your height. You are classed as increased risk. Take Care. Making changes to diet and exercising or increasing activity can reduce your central adiposity.
It is very important that you speak to your doctor about screening for cardiometabolic risk factors including blood pressure, HbA1c, and lipid profile. If you are an NHS patient, you should discuss weight management options with your GP. |
| 0.6 and above | Very High Risk | Your waist is significantly more than half your height. You are classed as very high risk. Take Action. This level of central adiposity is strongly associated with type 2 diabetes, cardiovascular disease, and premature mortality.
It is very important that you speak to your doctor urgently about comprehensive metabolic assessment, structured weight management programmes, and possible pharmacological interventions. You may also need assessment for sleep apnoéa and other obesity-related complications. |
What Should I Do If My Score Puts Me at Increased Risk?
If the Adiposity Ratio Service classifies you as ‘at increased risk’ or ‘very high risk’, it is very important that you speak to your doctor about screening for cardiometabolic risk factors.
NowPatient may also automatically qualify you for risk-reducing strategies such as the Weight Loss Programs Service. You will be notified if you are eligible.
Ask your doctor about programmes and services that could help reduce your central adiposity. These services will be different depending on where you live.
Does a High Adiposity Ratio Definitely Mean I Will Develop Health Problems?
No. The scores only indicate the likelihood of obesity-related health risks. They do not mean you will definitely develop these conditions. Early risk-based interventions and lifestyle changes — such as improving diet, increasing physical activity, and achieving weight loss — can significantly reduce your risks.
How Can I Track My Adiposity Ratio Over Time?
NowPatient provides a long-term trend graph that allows you to track your Adiposity Ratio over time. To view your trend graph, tap on the Adiposity Ratio Service Card and select ‘View Trend’ or ‘View History’. You can zoom in on specific time periods or view your complete measurement history.
The tracking system works as follows:
- Monthly reminders: You will receive a push notification and in-app reminder once a month, prompting you to update your waist measurement.
- Long-term trend graph: All your measurements are displayed on an interactive graph showing your WHtR history over time. The graph uses colour-coded zones (green, amber, red) so you can easily see which risk category you fall into.
- Progress tracking: The graph shows your trend direction — whether your WHtR is improving, stable, or worsening — so you can see the results of your efforts.
- Quick updates: Since your height doesn’t change, you only need to enter your new waist measurement each month. It takes just seconds to update.
Regular tracking allows you to:
- Monitor the effectiveness of diet and exercise changes
- See the impact of any weight loss medications
- Stay motivated by viewing your progress
- Share accurate, up-to-date information with your healthcare providers
- Catch any concerning trends early before they become serious
What Health Conditions Are Associated with an Elevated Adiposity Ratio?
Elevated WHtR (≥0.5) is associated with increased risk of the following conditions:
- Type 2 Diabetes Mellitus
- Cardiovascular Disease (coronary heart disease, stroke)
- Hypertension (high blood pressure)
- Dyslipidaemia (abnormal cholesterol levels)
- Metabolic Syndrome
- Non-Alcoholic Fatty Liver Disease
- Obstructive Sleep Apnoéa
- Increased all-cause mortality (for WHtR ≥0.6)
What Are the Symptoms of Obesity-Related Conditions?
Signs and symptoms that may indicate obesity-related health problems include:
- Increased thirst and frequent urination
- Fatigue and feeling more tired than usual
- Shortness of breath during normal activities
- Snoring or interrupted breathing during sleep
- Joint pain, particularly in weight-bearing joints
- Skin changes, including dark patches (acanthosis nigricans)
- Difficulty with wound healing
- High blood pressure readings
What Are the Limitations of the Adiposity Ratio Service?
The Adiposity Ratio calculation uses the Waist-to-Height Ratio (WHtR), a widely used and validated tool to assess central adiposity risk. As with any risk assessment screening, there are limitations:
Not Standalone
Should be used alongside other clinical assessments, not in isolation.
Abdominal Conditions
Results may be affected by ascites, pregnancy, or other causes of abdominal distension.
Height Extremes
Very short or tall individuals may require additional clinical judgement.
Fat Type
Does not distinguish between subcutaneous and visceral fat.
BMI Range
NICE recommends using WHtR for patients with BMI under 35 kg/m².
Self-Report Errors
Users may misreport waist or height measurements, which could affect the accuracy of the score.